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The American workforce is changing, creating new challenges for employers to provideoccupational health services to meet the needs of employees. The NationalAeronautics and Space Administration (NASA) workforce is highly skilled and competitiveand employees frequently work under intense pressure to ensure mission success. The Office of the Chief Health and Medical Officer at NASA requested that theInstitute of Medicine review its occupational health programs, assess employee awarenessof and attitude toward those programs, recommend options for future worksitepreventive health programs, and ways to evaluate their effectiveness. The committee'sfindings show that although NASA has a history of being forward-looking in designingand improving health and wellness programs, there is a need to move from atraditional occupational health model to an integrated, employee-centered programthat could serve as a national model for both public and private employers to emulateand improve the health and performance of their workforces.